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An intricate relationship between pain and depression: Clinical correlates, coactivation factors and therapeutic targets

机译：疼痛和抑郁之间的复杂关系：临床关联，共激活因子和治疗目标

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Introduction: An apparent clinical relationship between pain and depression has long been recognized, which makes an enormous impact on the individual health care. At present, the practical implication of such overlapping symptomatology between pain and depression is not clear, but the prevalence estimates for depression are substantially inflated among patients with chronic pain and vice versa. This interaction has been labeled as the depression-pain syndrome or depression-pain dyad. Areas covered: This article discusses the neurobiological substrates and neuroanatomical pathways involved in pain-depression dyad along with newer therapeutic targets. Expert opinion: Several key themes emerged from our review of the relationship between depression and pain. First, the diagnosis of depression in pain or vice versa is particularly challenging, and the development of better diagnostic framework that involves both pain and depression is particularly required. Secondly, the entwined relationship between pain and depression supports the possibility of common coactivating factors that results in their neurophysiological overlap. A broad understanding of the role played by the central nervous system (CNS) in the processing of pain and depression may eventually lead to the introduction of triple reuptake inhibitors, agomelatine, vilazodone and ketamine with novel mechanism of action, hence appear to be of promising potential for pain with depression.
机译：简介：长期以来，人们一直认为疼痛与抑郁之间存在明显的临床联系，这对个人医疗保健产生了巨大影响。目前，尚不清楚这种疼痛和抑郁之间重叠的症状学的实际含义，但是对于慢性疼痛患者，抑郁的患病率估计值实际上被夸大了，反之亦然。这种相互作用被标记为抑郁-疼痛综合症或抑郁-疼痛二联体。涵盖的领域：本文讨论了与抑郁症有关的神经生物学底物和神经解剖学途径以及较新的治疗靶标。专家意见：从我们对抑郁与疼痛之间关系的回顾中得出了几个关键主题。首先，痛苦中的抑郁症的诊断特别是挑战，反之亦然，特别需要开发同时涉及疼痛和沮丧的更好的诊断框架。其次，疼痛和抑郁之间的纠缠关系支持共同的共同激活因子导致其神经生理学重叠的可能性。对中枢神经系统（CNS）在疼痛和抑郁症治疗中的作用的广泛了解可能最终导致引入具有新作用机制的三重再摄取抑制剂，阿戈美拉汀，维拉唑酮和氯胺酮，因此似乎很有希望伴有抑郁症的潜在痛苦。

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